Vasodilator agents improve hemodialysis vascular access patency A population-based study from Korea

被引:1
作者
Kim, Do Hyoung [1 ]
Han, Donghoon [2 ]
Kim, Jaehwan [3 ]
Park, Hayne Cho [1 ]
Lee, Young-Ki [1 ]
Shin, Dong Geum [2 ]
Kang, Min-Kyung [2 ]
Cho, Jung Rae [2 ]
Choi, Seonghoon [2 ]
Lee, Namho [2 ]
机构
[1] Hallym Univ, Kangnam Sacred Heart Hosp, Dept Internal Med, Div Nephrol,Coll Med, Seoul, South Korea
[2] Hallym Univ, Kangnam Sacred Heart Hosp, Dept Internal Med, Div Cardiol,Coll Med, 1 Shingil Ro, Seoul 07247, South Korea
[3] Hanmi Pharm Co Ltd, Data Sci Team, Seoul, South Korea
关键词
hemodialysis; primary patency; vascular access; vasodilators; ARTERIOVENOUS-FISTULA; DIALYSIS; OUTCOMES; COMPLICATIONS; MATURATION; FAILURE; DISEASE; GENDER;
D O I
10.1097/MD.0000000000027439
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Vascular access (VA) failure is an important problem for patients undergoing hemodialysis, and maintaining VA patency is challenging. In this study, we used a nationwide database to investigate the effects of nitrate, as a vasodilator, on VA failure in hemodialysis patients. We investigated the Korean insurance claims data of hemodialysis patients who underwent angioplasty for VA failure between January 2012 and December 2017. The patients were divided into 2 groups: those not receiving vasodilator therapy (controls) and those receiving any vasodilator administration (vasodilator treatment, VDT). The primary endpoint was VA primary patency, defined as the time between arteriovenous dialysis access creation and the first percutaneous transluminal angioplasty (PTA). During the study period, a total of 6350 patients were recruited, 409 (6.4%) patients assigned to the VDT group and 5941 (93.6%) controls. PTA was performed in 998 patients (15.7%), including 8 in the VDT group and 990 controls. The VA site PTA rate was significantly lower in the VDT group (2.0%) than in the control group (16.7%, P < .001). In the subgroup analysis, the patency rates associated with the different vasodilators were similar (P = .736). All vasodilators, except molsidomine, improved the patency rate by approximately 20%. In this large national database study, vasodilator administration was associated with higher VA primary patency, compared with controls, in hemodialysis patients. VDT may have a beneficial effect on maintaining VA patency in patients undergoing hemodialysis.
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页数:6
相关论文
共 39 条
[1]   Complications of the Arteriovenous Fistula: A Systematic Review [J].
Al-Jaishi, Ahmed A. ;
Liu, Aiden R. ;
Lok, Charmaine E. ;
Zhang, Joyce C. ;
Moist, Louise M. .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2017, 28 (06) :1839-1850
[2]  
Allon M, 2000, KIDNEY INT, V58, P2178, DOI 10.1111/j.1523-1755.2000.00391.x
[3]   Relation between gender and vascular access complications in hemodialysis patients [J].
Astor, BC ;
Coresh, J ;
Powe, HR ;
Eustace, JA ;
Klag, MJ .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2000, 36 (06) :1126-1134
[4]   The effect of statin therapy on the formation of arteriovenous fistula stenoses and the rate of reoccurrence of previously treated stenoses [J].
Birch, Nathan ;
Fillaus, Jennifer ;
Florescu, Marius C. .
HEMODIALYSIS INTERNATIONAL, 2013, 17 (04) :586-593
[5]   A Review of Percutaneous Transluminal Angioplasty in Hemodialysis Fistula [J].
Bountouris, Ioannis ;
Kritikou, Georgia ;
Degermetzoglou, Nikolaos ;
Avgerinos, Konstantinos Ioannis .
INTERNATIONAL JOURNAL OF VASCULAR MEDICINE, 2018, 2018
[6]   The Biology of Hemodialysis Vascular Access Failure [J].
Brahmbhatt, Akshaar ;
Misra, Sanjay .
SEMINARS IN INTERVENTIONAL RADIOLOGY, 2016, 33 (01) :15-20
[7]   The molecular mechanisms of hemodialysis vascular access failure [J].
Brahmbhatt, Akshaar ;
Remuzzi, Andrea ;
Franzoni, Marco ;
Misra, Sanjay .
KIDNEY INTERNATIONAL, 2016, 89 (02) :303-316
[8]   The Role of Shear Stress in Arteriovenous Fistula Maturation and Failure: A Systematic Review [J].
Browne, Leonard D. ;
Bashar, Khalid ;
Griffin, Philip ;
Kavanagh, Eamon G. ;
Walsh, Stewart R. ;
Walsh, Michael T. .
PLOS ONE, 2015, 10 (12)
[9]   Preferred haemodialysis vascular access for diabetic chronic kidney disease patients: a systematic literature review [J].
Coentrao, Luis ;
Van Biesen, Wim ;
Nistor, Ionut ;
Tordoir, Jan ;
Gallieni, Maurizio ;
Monros, Anna Marti ;
Bolignano, Davide .
JOURNAL OF VASCULAR ACCESS, 2015, 16 (04) :259-264
[10]   Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial [J].
Diener, HC ;
Bogousslavsky, J ;
Brass, LM ;
Cimminiello, C ;
Csiba, L ;
Kaste, M ;
Leys, D ;
Matias-Guiv, J ;
Rupprecht, HJ .
LANCET, 2004, 364 (9431) :331-337